Screening for Prediabetes and Diabetes in Korean Nonpregnant Adults: A Position Statement of the Korean Diabetes Association, 2022

Abstract

Diabetes screening serves to identify individuals at high-risk for diabetes who have not yet developed symptoms and to diagnose diabetes at an early stage. Globally, the prevalence of diabetes is rapidly increasing. Furthermore, obesity and/or abdominal obesity, which are major risk factors for type 2 diabetes mellitus (T2DM), are progressively increasing, particularly among young adults. Many patients with T2DM are asymptomatic and can accompany various complications at the time of diagnosis, as well as chronic complications develop as the duration of diabetes increases. Thus, proper screening and early diagnosis are essential for diabetes care. Based on reports on the changing epidemiology of diabetes and obesity in Korea, as well as growing evidence from new national cohort studies on diabetes screening, the Korean Diabetes Association has updated its clinical practice recommendations regarding T2DM screening. Diabetes screening is now recommended in adults aged ≥35 years regardless of the presence of risk factors, and in all adults (aged ≥19) with any of the risk factors. Abdominal obesity based on waist circumference (men ≥90 cm, women ≥85 cm) was added to the list of risk factors.

2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association

“…Owing to the recent increase in the prevalence of prediabetes, diabetes, obesity, and abdominal obesity among young adults under the age of 40 [ 1 , 7 ], there have been suggestions for a change in previous screening criteria for diabetes (adults aged ≥40 and adults aged ≥30 years with risk factors) [ 2 ]. The Committee of Clinical Practice Guidelines of the KDA conducted a cross-sectional study on the age for diabetes screening in adults aged ≥20 years using data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2016 to 2020) and the Korean National Health Insurance Service sample cohort (2012 to 2017) [ 3 ]. In this study, when evaluating the number needed to screen (NNS) to identify one patient with diabetes according to age group, there was a significant change in NNS values in the 35 to 39 age group.…”

“…In the “screenings for diabetes” section, guidelines were updated to recommend screening for diabetes in all adults aged ≥35 years or those aged ≥19 years who have risk factors, reflecting a recent position statement on screening for prediabetes and diabetes in Korean nonpregnant adults announced by the KDA [ 3 ]. In the section “glucose monitoring and glycemic target,” the use of continuous glucose monitoring (CGM) devices was emphasized, and target values of key metrics for CGM have been added.…”

Efficacy and Safety of Once-Weekly Semaglutide Versus Once-Daily Sitagliptin as Metformin Add-on in a Korean Population with Type 2 Diabetes

“…The close association between obesity and T2D is well known, and overweight or obesity is recognised as a primary risk factor amenable to change in T2D [ 6 ]. In Korea, approximately half of adults with diabetes are obese, as defined by a body mass index (BMI) ≥ 25.0 kg/m 2 [ 4 , 5 , 8 ], and the Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) now recommends diabetes screening of all people aged ≥ 35 years, and selected people aged ≥ 19 years with identified risk factors, one of which is abdominal obesity [ 9 ].…”

Oxidative Balance Score and New-Onset Type 2 Diabetes Mellitus in Korean Adults without Non-Alcoholic Fatty Liver Disease: Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) Cohort

“…According to the International Diabetes Federation, since the first report was published in 2000, the prevalence of diabetes in adults aged 20-79 has more than tripled, from approximately 151 million (4.6% of the global population at the time) to 536.6 million (10.5%) as of 2021 [1]. South Korea is no exception, with an estimated 44.3% of adults aged 30 and over in 2020 having prediabetes, and the prevalence of diabetes reaching 16.7% [2]. Poorly controlled diabetes increases the risk of co-morbidities and all-cause mortality, including cardiovascular, cerebrovascular, and peripheral vascular diseases, in the long term [3].…”